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Block 1 - GI > Path 5,7 > Flashcards

Path 5,7 Flashcards

1
Q

If a trichrome stain of the liver is shown, and there is lots of blue, it is ___

A

Fibrosis

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2
Q

Accumulation of fat within hepatocytes

A

Steatosis

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3
Q

Mallory bodies are associated with ____

2. and are composed of ___

A
  • Alcoholic and nonalcoholic steatohepatitis
  • cholestatic conditions
  • Wilson disease
  1. Intracytoplasmic eosinophilic deposits of cytokeratin
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4
Q

Necrosis vs. apoptosis

A

Necrosis has inflammatory response apoptosis does not

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5
Q

Lymphoid follicles are common in hepatitis ___

A

C

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6
Q

Visible bile in tissue sections suggests ___

A

Cholestasis

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7
Q

In viral hepatitis, serum liver transaminases (ALT, AST) are ___

A

Markedly elevated early but will decrease as either the acute injury resolves or parenchyma is lost

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8
Q

3 leading causes of chronic hepatitis, liver failure, and cirrhosis

A

Chronic hep B and C
Nonalcoholic fatty liver disease
Alcoholic fatty liver disease

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9
Q

Chronic liver failure is most commonly associated with ___

A

Cirrhosis

*but not all cirrhosis leads to chronic liver failure

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10
Q

4 major consequences to portal hypertension:

A
  1. Ascites
  2. Formation of portosystemic shunts (which causes hemorrhoids, esophageal varices, can lead to massive hemorrhage and death)
  3. Congestive splenomegaly
  4. Hepatic encephalopathy
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11
Q

Flapping asterixis is a characteristic sign of ___

A

Hepatic encephalopathy

  • hand flapping tremor that often accompanies metabolic disorders
  • usually induced by extending the arm and dorsiflexing the wrist
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12
Q

___ is now the most common cause of acute liver failure necessitating liver transplantation in the US

A

Acetaminophen

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13
Q

Causes of liver failure

A
  • A: acetaminophen, hep A, autoimmune hep
  • B: hep B
  • C: hep C, cryptogenic
  • D: hep d, drugs/toxins
  • E: hep E, esoteric causes (Wilson, Budd-Chiari)
  • F: fatty change
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14
Q

Viral hepatitis transmissions

A

A and E: fecal-oral
B and C: parenteral, sexual, perinatal
D: parenteral
E: water borne, monkeys, cats, pigs, dogs

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15
Q

Which hepatitis is most commonly chronic?

A

C

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16
Q

Acute vs chronic hepatitis viruses

A

A and E are AcutE only
Consonants are Chronic
*except E in IC and pregnant people

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17
Q

___ is endemic in equatorial regions and frequently epidemic

A

Hep E

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18
Q

Autoimmune hepatitis characteristics

A
  • High serum titers of autoantibodies in 80% of cases
  • viral serologic markers are negative
  • young to middle-aged white females
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19
Q

Forms of alcoholic liver disease

A
  1. Hepatitic steatosis
  2. Alcoholic hepatitis
  3. Alcoholic cirrhosis
20
Q

Mallory bodies are found in ___

A

Alcoholic hepatitis

21
Q

Hereditary form of iron overload are

A

Hemochromatosis

22
Q

Iron overload secondary to transfusions, ineffective erythropoiesis, increased oral intake, chronic liver disease, etc.

A

Hemosiderosis

23
Q

Iron granules are ____ with H&E stain and ____ with Prussian Blue stain

A

Golden brown

Dark blue

24
Q

In Wilson disease, serum ceruloplasmin levels are ___

A

Low

  • copper levels are no help
  • hepatic copper quantitation, and urinary copper levels help dx as well
  • genetic testing is available
25
Q

Clinical presentation of Wilson disease

A 
Neuropsychiatric disturbances 
Parkinson-like tremors
Clumsiness
Difficulty speaking 
Kayser-Fleiscger rings (green to brown deposits of copper in the eye)
26
Q
  1. Clinical features of alpha-1 antitrypsin deficiency?

2. Labs?

A
  1. Neonatal hep with jaundice in some cases, adolescents present with symptoms related to cirrhosis, hepatitis, or pulmonary disease, adults can develop hepatocellular carcinoma. Emphysema in some
  2. Low levels of serum alpha 1 antitrypsin. PAS positive and diastase-resistant inclusions
27
Q

Obstruction of extrahepatic bile ducts
No sex predilection
No antibodies
*Symptoms?

A

Secondary biliary cirrhosis

*pruritis, jaundice, malaise, dark stools, hepatosplenomegaly

28
Q

Primary sclerosing cholangitis (PC) is commonly seen in association with ___

A

IBD, particularly chronic UC

29
Q

Middle aged women
Autoimmune
Antimitochondrial antibodies

A

Primary biliary cirrhosis

30
Q

Young males
Immune-mediated injury
No autoantibodies

A

Primary sclerosing cholangitis (PC)

31
Q

All of the reactive and neoplastic conditions covered in class arise from hepatocytes except ___

A

Cholangiocarcinomas , which arise from bile ducts

32
Q

Most common congenital anomaly of the pancreas

A

Pancreas divisum

-failure of ducts to fuse

33
Q

Band like ring of normal life pancreatic tissue around the 2nd part of duodenum

A

annular pancreas

34
Q

M vs W
Acute pancreatitis caused by:
1. Gallstones
2. Alcohol

A

I. F 3:1

2. M 6:1

35
Q

Saponification occurs in ___

A

Acute pancreatitis

36
Q

Lab findings for acute pancreatitis

A

Amylase ⬆️

Lipase ⬆️

37
Q

Most common cause of chronic pancreatitis

A

Alcohol abuse

38
Q

Relevant populations in cystic fibrosis?

Gene mutation?

A

Caucasians
Uncommon in Asians and Africans
*CFTR gene on 7q

39
Q

Relevant populations in serous cystic neoplasms (cystadenomas)

Where are they found?

A

F 2:1
7th decade

Usually in the tail of the pancreas

40
Q

Relevant populations in mucinous cystic neoplasms (cystadenomas)

A

95% in women

Body and tail
Slow growing
Lined by columnar epithelium

41
Q
  1. The majority of pancreatic carcinomas are ___
  2. Risk factors?
  3. Most occur where?
A
  1. Adenocarcinomas
  2. smoking, drinking, chronic pancreatitis, obesity, diabetes
  3. Head
42
Q

Esophageal symptoms worthy of endoscopy

A 
Dysphagia
Weight loss
Chest pain when cardiac problem is ruled out 
Hematemesis
Melena
43
Q

Reasons to screen for adenocarcinomas of the esophagus

A

GERD
Smoking
Obesity
Hiatal hernia

44
Q

No good cancer screening recommendations exist for ___

A

Esophageal squamous cell carcinoma
Gastric adenocarcinomas
Pancreatic cancer

45
Q

Screening tests for colorectal cancer

A 
fecal occult blood test
Fecal immunochemical test
Cologuard 
Flexible sigmoidoscopy 
Colonoscopy
46
Q

Age for screening for colorectal cancer?

A

Over 50

Block 1 - GI (15 decks)

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